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Open Sourcing Surgery

The project idea is to design custom surgical instruments like retractors both in size or shape and 3d print them

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Who hasn't been in the situation that your surgical retractor is too small or too big for a certain procedure?, yeah, i know right?, it happens to everybody..
My idea for this project is to bring access to surgical instruments to everybody who can use a 3d printer. A database of pre-made instruments can be available on sites like thingiverse. This gives at least two possibilities: cheap availability of instruments in countries with less resources or custom instruments for specific purpouses.
The instrument can be designed with free software like 123d and of course be open source.
Eventually implantable devices can also be made

Goals:

- Free (or at least really cheap)

- Easy

- Available

- Open source

- Automate: the instruments used have QR code which is scanned when used and reported to the printer queue, so a replacement can be printed and keep stock stable

- Usable (with real application)

Steps:

- design the instrument with 3d software

- build 3d printer with scrap parts (i think i can build it only buying the hot end. I already have a semiworking machine that i will be testing as plotter soon, if it works i'll start adding the hot end, extruder, hot bed and all the 3d print related elements).

- print an actual instrument like a retractor

- test it in real life application (i.e. surgery)

- enjoy Nobel prize =P

123dx - 189.87 kB - 03/17/2016 at 02:16

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  • 1 × PLA Plastic filament
  • 5 × Nema 17 stepper motor
  • 1 × RAMPS shield or any stepper driver of choice
  • 1 × Atmel Atmega328 Microprocessors, Microcontrollers, DSPs / ARM, RISC-Based Microcontrollers
  • 1 × Arduino Mega

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  • Ideas are welcomed

    leandro07/13/2016 at 18:04 0 comments

    I was thinking..

    if anyone would like to have a medical/dental instrument 3d printed and/or customized, you can send me which instrument (with specs if possible) so i can make a 3d model to be tested.

  • Full scale testing

    leandro07/11/2016 at 18:34 0 comments

    This week i'll start printing a full scale model of the retractor and test it's capabilities. Also adding a raspberry pi 3 model B to achieve automation by wifi communication and Octoprint.

  • First print

    leandro06/07/2016 at 23:09 0 comments

    First test print scaled 50%. The printer needs still a lot of calibration

  • Started printing

    leandro05/26/2016 at 15:25 0 comments

    It took a lot of time and effort, but i started printing, for now it's only calibration cubes, but soon the first retractor.

    Here is a pic of my repstrap

  • Struggle

    leandro04/28/2016 at 16:00 0 comments

    Still struggling with the 3d printer and the shortage (lack) of free time, but almost ready to print

  • Almost

    leandro04/13/2016 at 04:30 0 comments

    almost done with the 3d printer, getting there

  • Updated steps

    leandro04/02/2016 at 02:23 0 comments

    The first stage of the project is to design, print and test a surgical retractor. Second stage will be a needle driver and dissection clamps (suture kit). Third stage will be testing sterilization methods (ethylene oxide or Sterrad), bacterial growth, allergies and different materials (like PLA or ABS).

  • On the way

    leandro04/02/2016 at 02:11 0 comments

    I am expecting the hotend and extruder to arrive next week. If everything goes well i could be printing a test retractor the week after

  • Update (goals and printer)

    leandro03/27/2016 at 06:34 0 comments

    I don't know why i remembered today my days in a public hospital's emergency room (a few years ago), there were no suture kits (actually there was one, reserved for face wounds), consisting of needle driver and dissection pliers. The other wounds were sutured with an intramuscular injection needle and linen threads (i don't know the exact translation, it is an outdated - obsolete (but really cheap) type of suture).

    One updated goal of this project is to provide to cheap and available suture kits for hospitals and health providers with limited resources (or just everyone for that matter).

    UPDATE: i finished the XYZ axes of my scraps made 3d printer, now i am improving and calibrating (as plotter) them. I'll try next week to get the hotend and extruder (the only thing i am planning to buy). I hope i'll have a functional printer within 2 or 3 weeks.

  • Findings

    leandro03/20/2016 at 06:20 0 comments

    Today i saw online an antibacterial 3d printing filament, i didn't know about it, but it could be a great improvement for the project.

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Discussions

Kirsten Roling DDS wrote 03/16/2016 at 17:43 point

This is an exciting concept. Dentistry uses plastic instruments and devices for specific applications. 

  Are you sure? yes | no

leandro wrote 03/16/2016 at 18:38 point

Thanks, thinking a little bit forward, one can print temporary spacers for teeth or templates for making prothesis.

Also "mouth openers?" (i don't know the term in english, i mean these
) and ferules

  Are you sure? yes | no

Kirsten Roling DDS wrote 03/16/2016 at 18:43 point

There are many uses, isolation, retractors, space maintainers for children who lose a primary tooth too early, mixing utensils, etc. Great idea. For the record in a public health application plastic instruments could be useful and get care to those who may otherwise not have access

  Are you sure? yes | no

Kirsten Roling DDS wrote 03/16/2016 at 18:45 point

we also have disposable hand piece attachments for dental prophylaxis. 

  Are you sure? yes | no

leandro wrote 03/16/2016 at 19:04 point

those are great ideas, maybe if my basic project works we can develop something together dentristy oriented in the future

  Are you sure? yes | no

leandro wrote 03/16/2016 at 14:40 point

it doesn't have to be cheap plastic, just cheaper than steel. 

The main reason for using stainless steel is that they are durable and can withstand sterilization with heat. There are papers that demonstrated that it can be sterile printed and secure to use. Plastic instruments won't aim for durability but to cost-effectivity and can be also sterilized with ethilene oxide that doesn´t affect the plastic.

Also plastic instruments are better than no instruments (believe it or not some countries don't have resources)
The other possibility is to print custom instruments that are not available in steel instruments catalogs with special sizes or shapes for special purposes

  Are you sure? yes | no

Martin wrote 03/16/2016 at 10:52 point

Surgical instruments are made from of good stainless steel out of good reasons. 3D printing this is now where cheap or free. And I would not want instruments or even implants made of cheap plastics.

  Are you sure? yes | no

Brian wrote 04/02/2016 at 02:49 point

I agree. You can actually buy most instruments in stainless steel from China or Pakistan for less cost than you could print them. And the number of items required to have any impact on the demand would necessitate the printer be on site (a large up front cost unless given to them for free), and running 24 hours a day, and it would still not fill the demand. Plastic instruments, like the cheek retractors shown in the image above, are already available and (again) less than the cost of an FDA approved plastic for printing, and the FDA approval for some devices could take years. 

If you must go plastic, print one and build a low cost injection molding machine to mass produce the item.

  Are you sure? yes | no

leandro wrote 04/02/2016 at 03:28 point

Believe it or not, in some countries like Argentina (where i live) imported products even from China or Pakistan are not only really expensive (there is a poor national industry and importers take advantage of the situation) but also, at least for now, restricted. Not everyone can import products, the taxes are huge (plus bribing), the logistics are awful and you may not even get to take your import from customs, losing your money and time. There are lots of people here that can't follow their treatment because even the drugs (like oncological) can't get through customs, the situation is THAT bad.

Everywhere when some instrument breaks or it no longer functions as it should, gets replaced. Here, in public hospitals and some private ones, when that happens the result is that you end up loosing it and it could be years (and begging and fighting) to get a replacement. The laparoscopic instruments for example are disposable one use in countries like USA, here they are re-sterilized and used until they break....

You could say that all of the above applies to 3d printers. That is true for the commercial ones, but the materials to build a 3d printer are available in the country. I am building one with scraps, motors from old printers and scanners, it's not super accurate, but i can improve it later with national products (rods, bearings, etc). The cost so far is $0, the only thing i'm buying (for the sakes of time) is the hot end and extruder which cost here about U$S 80 but it could be far less if i had time to build them myself.

Plus the customization or creation of instruments for innovative surgeons it's harder to achieve with metal..

  Are you sure? yes | no

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